[00:00:00] Adam Walker: From Susan G. Komen, this is Real Pink, a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] We need to talk about Black breast health. Black women are about 40% more likely to die of breast cancer than white women, diagnosed at younger ages, at later stages and with more aggressive breast cancers leading to poorer outcomes. This monthly podcast series, Stand for H.E.R. – Uniting to Create a Health Equity Revolution, opens a national dialogue that engages community members and organizations, health care providers, research scientists, and opinion and policy leaders to discuss recommendations and actionable strategies to advance breast health equity in the Black community.
[00:00:51] Komen’s free, virtual 10-week patient navigation training program provides specific training for patient navigators to ensure they can help Black patients overcome barriers to receiving high-quality care and treatment. The patient navigation training program takes a multifaceted approach to addressing inequities and barriers in the health care system, first and foremost by connecting patients to resources and support at every step of their breast care journey. We are excited to discuss how Komen trains patient navigators to be culturally responsive with Kelley Moultry, Komen’s Patient Navigation and Outreach Coordinator. Welcome to the show, Kelley!
[00:01:32] Kelley Moultry: Thank you. I’m happy to be here.
[00:01:34] Adam Walker: I’m real excited to talk to you about this. Patient Navigators are just so critical and so profoundly helpful. And so first I’ll just start by saying thank you for the work that you’re doing there. It’s just so, so profound. So, can you tell us about your work at Komen? What does your role entail as a Patient Navigation and Outreach Coordinator?
[00:01:57] Kelley Moultry: Yeah, so I work with Kyondra Fox, who’s the manager of a Patient Navigation and Outreach, and my role was designed to enhance the training aspect of Komen’s Patient Navigation program. So creating sort of a community, peer-focused training for the next generation of Patient Navigators. And we do this by providing tools, resources, and strategies for these Navigators to utilize while they’re facing those barriers that come with navigating historically marginalized communities. And my role is to continue advancing these efforts and to help create an interactive experience for those within our program and create a peer network for them that many Patient Navigators don’t have prior to beginning the program.
[00:02:40] Adam Walker: Oh, that’s fantastic. Okay. Okay, so then walk us through what does the training program look like for Patient Navigators? How long does it take to complete? Give us the behind the scenes here.
[00:02:53] Kelley Moultry: Yeah, so our Patient Navigation Training Program, it’s constantly evolving because needs are always evolving. So right now our program is 12 weeks, and it consists of two kind of pre-selected required courses and our Navigating Racism courses, a racism course is a part of that. And then there’s also two elective courses of their choosing that they can pick from our catalog. Then the last requirement is attending two of our virtual events within the Komen Patient Navigation program. And so we kind of just send out reminders each month about any events that we’re offering and they can choose to sign up for whichever one kind of speaks to them.
[00:03:33] And so this is where the interactive part of it really comes into play. So our events are sort of a chance for navigators to expand their network and sharpen their skills around patient navigation. So our events can include panel discussions, workshops, and our grand round series, which is sort of like a real life case study where Navigators can bring any challenging cases to the table for just extra peer support. So even though our program is 12 weeks, our navigators become a part of our community and they’re encouraged to continue to be an active participant within Komen’s Patient Navigation community. And as I said before, our needs are constantly evolving. So we just like to make sure that we continue to provide a space for them even after they’ve completed the program.
[00:04:20] Adam Walker: Okay, so as you’re talking, it occurred to me that maybe I skipped a basic question. I should have started with. So if you don’t mind me, like throwing you just a very easy curve ball here. Can you just define what Patient Navigation actually is and what Patient Navigators do.
[00:04:39] Kelley Moultry: Yeah, so Patient Navigators are sort of like a special resource for patients. So when patients are going through something just like a cancer diagnosis, it’s kind of an extra support system for them. It’s someone who has knowledge of the process that they’re about to go through. Someone who’s has access to resources, someone who has communication with their healthcare team, and kind of help become like a guide or a facilitator with that patient just to make sure that they have some type of support system that understands what’s going on.
[00:05:13] Adam Walker: Okay, and let’s just pretend that I’m sitting next to a breast cancer patient. They need a Patient Navigator. Do they pay for that? Like how does that part work? If you don’t mind me asking?
[00:05:27] Kelley Moultry: Yeah, they normally do not pay for a Patient Navigator. Normally they’re employed by the hospital or, in this case, if you’re thinking about a Komen Patient Navigator, they’re employed by Susan G. Komen. And they are a free resource for you. Sometimes you can connect by reaching out to us directly, or we meet people through our Patient Center Helpline, and then we connect you with that Patient Navigator who can help you through this process or this journey.
[00:05:56] Adam Walker: Okay, perfect. Thank you. That, that, that helps me to set the stage. I, I really appreciate it. So we’re, this is a part of the Stand For H.E.R. Series talking about health equity. So Komen’s program’s unique because it includes a racism bias training course. Can you tell us more about the course and why it’s important for Patient Navigators to take that?
[00:06:18] Kelley Moultry: Yeah, our Navigating Racism and Bias course is one of the highlighted courses in our program. It is such an essential course that highlights the historical context of racism bias, and it also emphasizes how understanding the role of systematic racism and the healthcare system can help navigators equitably navigate Black patients. These levels of racism have a major effect on a Black patient’s journey when it comes to the quality of healthcare that they receive. There can be many barriers to overcome. One of the roles of this course is to first make sure that we understand this historical context, and the next goal is to empower the navigators with the tools that they need to help patients navigate through the systemic bias, racism, and microaggressions that they may face in their journey. A major part of that is learning how to advocate for your patient and support their self-advocacy, and also how to leverage the patient’s bill of rights in order to do that. So this course is just to make sure that our Patient Navigators are empowered with practical tools to navigate systematic bias and understand the why’s behind what’s being experienced.
[00:07:31] Adam Walker: That’s fantastic. So if you don’t mind me asking, as someone who has certainly studied this topic and still is very ignorant on it in many ways. Can you give us like just some typical examples of the things that you train Patient Navigators towards, to help alleviate some of the biases. Just some practical examples, if you don’t mind walking us through that.
[00:07:59] Kelley Moultry: Well, one of the things that we try to teach our Patient Navigators are things like shared decision making and kind of meeting people where they are. So understanding the cultural beliefs, their religious beliefs that are taking place, and how it may affect the decisions that are being made with their healthcare journeys. So sometimes we have patients that are labeled as non-compliant because they simply… maybe their religious values or their cultural values don’t allow them to do specifically what their physician or oncologist is referring them to do. So we look at things like other resources, we look at ways to kind of work around some of those barriers.
[00:08:38] And we try to take baby steps with people when it comes to setting those goals and taking steps forward and making sure that they’re comfortable with those steps. So we provide additional tools throughout the training, like resource allocation talking about those biases. We’re looking at how the healthcare system works. How does payment work? So it’s kinda a full breakdown of what the healthcare system looks like and all those topics that you may have to be involved in when you’re navigating a patient.
[00:09:12] Adam Walker: I mean, that was… that’s really helpful. Like I, because I don’t, when I think about the inequities in healthcare, I don’t know that I would’ve immediately thought about a patient’s potential cultural influence being at odds with medical care. But now that… as soon as you said it, it’s well, of course that could be the case. And we would need to find ways to support through that. So, that was really helpful. I really appreciate that. So I guess, who else? I mean, maybe myself based on your answer, but who else would benefit from taking this course? I mean, outside of Patient Navigators and why? And what could other groups gain from this?
[00:09:51] Kelley Moultry: This is a course that could really benefit all health professionals as we see that the barriers come up across the board. So while it’s geared towards Patient Navigators, we have seen that it is an effective training for nurse navigators, for social workers, community health workers, health administrators, really any health profession that requires that face-to-face patient interaction where you have a chance to provide education and resources to aid them on their journey. The program is built through a health equity lens, and the solutions provided can really be applied both systematically and individually.
[00:10:30] Adam Walker: I love that. Okay. And so one aspect of Komen’s Patient Navigation Program is training navigators to meet patients where they’re at, which I think we’re kind of talking about. Can you explain more about like kind of what that means? And how that program prepares its Navigators for that?
[00:10:46] Kelley Moultry: Yeah, so what we’re saying is to meet patients where they are, but not where you want them to be. As healthcare professionals, we have a goal, and that goal is to get that patient to an improved state of health. But we have to remember that how they get there is negotiable. So one of tthe barriers that patients have that contributes to the lack of trust that particularly Black people face within the healthcare system is the lack of shared decision making, which we talked about. But we have to respect our patients’ autonomy.
[00:11:20] Every patient is an individual. They have their own barriers. This can be physical, mental, emotional, financial. The list goes on. You may have patients that come from a different background from you. They have different cultures, values, and beliefs that may all play a role in why they make certain decisions or have lifestyles that influence their health decisions and outcomes. So meeting them where they are means respecting that. It means educating yourself on that. It means being a facilitator. So analyzing where they are, what those barriers are, and guiding them through those barriers by simply just making sure that they have the knowledge and resources necessary to take a step forward how they feel most comfortable doing so.
[00:12:05] Adam Walker: So, I mean, I think what I’m hearing you say… and I just want to ask like to very overly simplify it. It sounds like it’s a lot of empathy, like a lot of like really understanding their perspective where they’re at, which strikes me as just profoundly important through medical care, especially through breast cancer medical care. And I wrote this down too, you said: Meet them where they’re at, not where you want them to be. Which I think is probably great life advice for like almost every part of life right there. So that was really good.
[00:12:35] Kelley Moultry: And empathy is definitely a big part of that. That’s also one of our trainings and events. We have a motivational interviewing workshop that’s coming up next month that I’ll be hosting. And it’s motivational interviewing and empathy because the two kind of Yeah. Come together. It’s such an essential skill for a Patient Navigator to have when you’re dealing with such a diverse group of people.
[00:12:57] Adam Walker: That’s right. That’s right. That’s fantastic. So have you personally benefited from taking this training in racism and bias and what was the most important learning from that training?
[00:13:08] Kelley Moultry: Yeah, it was one of the first trainings that I took when I came on with Komen. The training is simply eye-opening as a whole. But I would say for me, personally, is the part that pieces together the why. The course does a fantastic job at putting this timeline together that sort of leads up to the current state of resistance and mistrust that my community faces that leads all the way up to the recent COVID vaccination efforts. And so I was able to just connect this with my own experiences. Experiences of family, experiences of friends and patients. Because this is something that I am seeing happen live. I am seeing these statistics happening live. We, as a society, we tend to look at things like racism as a thing of the past. But the training highlights how the past has led up to this present state in that there’s still a pressing issue that requires special attention. And I think this training helps people see things from a different point of view, regardless of what you come in with. Because we all have something to learn no matter how much we think we have learned regarding this issue.
[00:14:18] Adam Walker: We all have a lot to learn. I have a lot to learn. And that’s honestly why I genuinely appreciate you, you coming on and talking to us about this. So Kelley, last question. How can our listeners who are interested in signing up for Komen’s Patient Navigation Program learn more?
[00:14:35] Kelley Moultry: Yeah, so they can contact us directly at NavigationNation@Komen.org. So if you want more information or you want us to get you enrolled, you can email us there. Or you can directly sign up by visiting, NavigationNation.LearnUpon.com and that’ll send you straight to our learning portal where you can go ahead and register and get started.
[00:14:56] Adam Walker: Oh, that’s fantastic. That’s NavigationNation@Komen.org. If you want to find out more, please feel free to do. Kelley, this has been fantastic. I really appreciate the information that you shared with us, and thank you for putting up with a few of my curve balls along the way.
[00:15:12] Kelley Moultry: Thank you. I had fun.
[00:15:15] Adam Walker: Join us as we Stand for H.E.R. to drive a Health Equity Revolution where we’ll create a world without inequities where Black people have the same chances of surviving breast cancer as anyone else. To learn more about Stand for H.E.R. and advancing breast health equity at Susan G. Komen, please visit https://komen.org/StandForHER.
[00:15:45] Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit RealPink.com. For more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam, you can find me on Twitter @AJWalker or on my blog, AdamJWalker.com.